Sports Medicine : Sports Medicine Injuries : Plantar Fasciitis

Plantar Fasciitis

Plantar fasciitis is the onset of inflammation in the arch supporting tissue structures on the bottom of the foot. This can occur as either an acute or chronic condition. Sufferers usually complain of pain in the heel and/or the arch of the foot. The pain often is worse with the first few steps of the day or after sitting. 

Treatment

After diagnosis, treatment consists of icing the bottom of the foot several times per day. It is often recommended to roll a frozen bottle of water along the bottom of a sock covered foot for five to minutes.

Stretching the foot is crucial — especially prior to the first steps of the morning. From a sitting position, before stepping out of bed, a patient should hold one end of a towel in each hand and loop the center around the ball of the foot with the knee extended. Pulling the towel against the foot, the patient should feel a stretch in the calf and along the bottom of the foot.

While active during the day, two alternative stretches have the same effect. One is to place the ball of foot on the edge of a step, letting the heel drop down from edge. Another is to place the ball of the foot on the base of a wall while the heel is on floor, keeping the knee straight while leaning toward the wall.

All three stretches must be held for a minimum of 30 seconds with a gentle stretching sensation felt.

Other effective treatments include physical therapy for taping, stretching, orthotic fabrication, ultrasound and iontophoresis (local steroid or acetic acid passed through the skin via a comfortable electric impulse).

Goals of physical therapy include pain relief, normalized ambulation and return to previous level of function. It is best to wear shoes that support the arch and cup the heel. A physical therapist or physician might also recommend a night splint — many models allow comfort for sleeping while providing a stretch. 

Physicians may perform steroid injections to the site to decrease local inflammation and pain. When all other treatments are ineffective, surgical intervention options include a complete release of the tissue, localized fascial disruption or radiofrequency ablation.